Table 2.
Predictors of Out-of-Network Use among Mental Health and General Medical Populations
| Characteristics | Out-of-Network Use† Odds Ratio (95% Confidence Interval)
|
||
|---|---|---|---|
| Mental Health n = 849
|
|||
| General Medical n = 7786 | Model 1 | Model 2 | |
| Age | |||
| 18–29 | 1.12 (0.73–1.71) | 0.48 (0.19–1.25) | 0.59 (0.22–1.54) |
| 30–49 | 0.72* (0.55–0.94) | 1.17 (0.70–1.97) | 1.16 (0.67–1.99) |
| 50–64 | 1 (reference) | 1 (reference) | 1 (reference) |
| Sex | |||
| Male | 1 (reference) | 1 (reference) | 1 (reference) |
| Female | 1.50* (1.11–2.04) | 1.66 (0.96–2.89) | 1.51 (0.84–2.73) |
| Race | |||
| White | 1 (reference) | 1 (reference) | 1 (reference) |
| Nonwhite | 0.96 (0.67–1.38) | 0.59 (0.28–1.27) | 0.57 (0.26–1.28) |
| Marital status | |||
| Married/living with partner | 1 (reference) | 1 (reference) | 1 (reference) |
| Divorced/separated/widowed | 0.99 (0.65–1.52) | 1.88 (0.95–3.71) | 1.88 (0.91–3.89) |
| Never married | 1.42 (0.94–2.14) | 3.03* (1.41–6.51) | 2.87* (1.35–6.12) |
| Education | |||
| High school or less | 1 (reference) | 1 (reference) | 1 (reference) |
| Some college | 1.33 (0.86–2.07) | 1.33 (0.50–3.52) | 1.15 (0.42–3.16) |
| Bachelor’s degree or higher | 1.26 (0.81–1.97) | 1.21 (0.47–3.11) | 1.06 (0.40–2.80) |
| Income (per year) | |||
| < $35,000 | 1.21 (0.76–1.95) | 0.47 (0.20–1.08) | 0.47 (0.20–1.12) |
| $35,000–$59,000 | 0.48* (0.33–0.72) | 0.22* (0.10–0.49) | 0.22* (0.09–0.51) |
| $60,000–$100,000 | 0.71* (0.52–0.97) | 0.67 (0.36–1.25) | 0.80 (0.41–1.55) |
| > $100,000 | 1 (reference) | 1 (reference) | 1 (reference) |
| Residence in metropolitan area | |||
| Yes | 1.12 (0.72–1.74) | 1.02 (0.43–2.42) | 0.69 (0.22-2.17) |
| No | 1 (reference) | 1 (reference) | 1 (reference) |
| Region of country | |||
| Northeast | 1.19 (0.80–1.77) | 1.01 (0.50–2.04) | 0.90 (0.44–1.87) |
| Midwest | 0.96 (0.66–1.39) | 0.42* (0.20–0.89) | 0.34* (0.15–0.81) |
| South | 1.18 (0.81–1.71) | 1.19 (0.60–2.35) | 1.29 (0.67–2.51) |
| West | 1 (reference) | 1 (reference) | 1 (reference) |
| Health status (self-reported) | |||
| Excellent, very good or good | 1 (reference) | 1 (reference) | 1 (reference) |
| Fair or poor | 1.74* (1.11–2.73) | 1.27 (0.56–2.86) | 1.39 (0.59–3.31) |
| No. psychiatrists per 100,000 | |||
| < 7 | — | — | 1 (reference) |
| 7–12 | — | — | 1.66 (0.77–3.56) |
| 13–18 | — | — | 1.46 (0.65–3.27) |
| ≥ 19 | — | — | 2.33* (1.10–4.93) |
Model 2 includes number of psychiatrists per 100,000.
*
P < 0.05.
†
Models predict any out-of-network use and include either inpatient or outpatient contacts.